【摘要】 目的:探讨右美托咪定对妇科恶性肿瘤经腹手术患者肠道功能、血清肠脂肪酸结合蛋白(IFABP)及二胺氧化酶(DAO)的影响。方法:经腹手术治疗的妇科恶性肿瘤患者128例随机分为观察组和对照组,每组64例。两组均采用相同方法进行麻醉诱导及麻醉维持,观察组气管插管后静脉给予右美托咪定直至术毕,对照组则给予等体积0.9%氯化钠溶液相同速率静脉输注。分别于麻醉诱导前(T0)、麻醉插管后5 min(T1)、气腹30 min时(T2)、关闭气腹后20 min(T3)、拔管后5 min(T4)以及术毕24 h(T5)检测两组患者的平均动脉压、心率等参数以及血浆皮质醇(Cor)、去甲肾上腺素(NE)水平;比较两组患者手术前后24 h血清IFABP、DAO水平变化;比较两组患者的临床资料和药品不良反应发生情况。结果:两组患者气腹时间、麻醉清醒时间无明显差异(P>0.05),观察组肠道功能恢复时间显著短于对照组,尿量显著多于对照组(P<0.01)。T1～T4时刻,对照组的平均动脉压、心率、血浆Cor和NE水平均显著高于本组T0时(P<0.01),观察组仅心率较本组T0时明显升高(P<0.01),其他指标无明显变化(P>0.05);观察组平均动脉压、心率、Cor和NE水平均显著低于对照组(P<0.01)。术后24 h对照组血清IFABP和DAO水平均较术前明显升高(P<0.01),且显著高于观察组(P<0.01);观察组血清IFABP和DAO水平较术前无明显变化(P>0.05)。两组患者药品不良反应发生率差异无统计学意义(P>0.05)。结论:右美托咪定可稳定经腹手术治疗的妇科恶性肿瘤患者的血流动力学,抑制应激反应的发生,且有助于术后肠道功能的恢复。更多还原

【Abstract】 Objective: To investigate the effect of dexmedetomidine on intestinal function,serum iFABP and DAO in patients with gynecological cancer undergoing abdominal operation. Methods: Totally 128 patients with gynecological malignant tumor were divided randomly into the treatment group and the control group with 64 cases in each group. The same method was used for anesthesia induction and maintenance in both groups. After tracheal intubation,the patients in the treatment group were given dexmedetomidine intravenously until the end of the operation,while the patients in the control group were given 0.9% sodium chloride. The clinical data of the two groups were compared. Before anesthesia induction(T0),5 minutes after anesthesia intubation(T1),30 minutes after pneumoperitoneum(T2),20 minutes after closure of pneumoperitoneum(T3),5 minutes after extubation(T4) and 24 hours after operation(T5),the mean arterial pressure,blood pressure and the levels of Cor and NE were measured. The serum levels of iFABP and DAO were measured and compared before operation and 24 hours after operation. The adverse reactions in the two groups were also compared.Results: There were no significant differences in pneumoperitoneum time and anesthesia awake time between the two groups(P >0.05). The recovery time of intestinal function in the treatment group was significantly shorter than that in the control group,and the urine volume was significantly higher than that in the control group(P<0.01). From T1 time to T4 time,the average arterial pressure,heart rate,plasma cor and NE levels in the control group were significantly higher than those in the group T0 time(P<0.01),only the heart rate in the observation group was significantly higher than that in the group T0 time(P<0.01),and other indexes had no significant change(P>0.05); the average arterial pressure,heart rate,cor and NE levels in the observation group were significantly lower than those in the control group(P<0.01). The serum levels of iFABP and DAO in the control group 24 hours after operation were significantly higher than before operation and observation group(P<0.01). The serum levels of iFABP and DAO in the observation group did not change significantly compared with those before operation(P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Dexmedetomidine can stabilize hemodynamics,inhibit the occurrence of stress reaction,and help the recovery of intestinal function.更多还原